What Organizations Outside the United States Should Know About the Global Gag Rule

The United States is the largest global donor of family planning assistance, and this investment has played a crucial role in preventing unintended pregnancy and unsafe abortions and improving maternal health worldwide. 

That progress will be stalled if, as expected, the new Trump administration reimposes the so-called global gag rule, a policy that weaponizes US abortion politics to hobble family planning programs around the world. This page aims to equip global advocates with information and resources to safeguard essential sexual and reproductive health services during the transition period.

Understanding the Global Gag Rule

The global gag rule applies to nongovernmental organizations (NGOs) based outside of the United States that receive US global health assistance. It prohibits these organizations from using their own, non-US funds to provide abortion services, information, counseling or referrals, or to participate in abortion-related advocacy. The policy has been alternately implemented by Republican administrations and rescinded by Democratic administrations since it was first introduced in 1984.

During the first Trump administration, however, the policy was expanded to apply not only to family planning programs but to nearly all global health funding, including programs addressing HIV and AIDS, tuberculosis, malaria, and maternal and child health. For many countries relying on US funding for health programs, expansion of the gag rule led to reductions in access to essential reproductive health services, worsened health outcomes, and created a chilling effect that prevented organizations and individuals from taking part in any meetings or discussions about reproductive health care that might have included abortion.

What to Expect from the Second Trump Administration

As the Trump administration returns to office in 2025, we anticipate significant changes in funding for and policies related to international family planning and sexual and reproductive health and rights. Because of his first-term actions and the proposals put forth as part of Project 2025, we expect Trump will take the following actions:

  • Reinstate and expand the global gag rule: Project 2025 proposes expanding the gag rule beyond its most recent incarnation to apply to all foreign assistance, including humanitarian aid, and strengthening its enforcement mechanisms.
  • Defund important international organizations: Project 2025 advocates blocking US funding to the United Nations Population Fund (UNFPA) and other organizations that promote sexual and reproductive health and rights—a move that would significantly hinder international efforts to improve access to family planning, maternal health and gender-based violence prevention, particularly in low- and middle-income countries.
  • Prioritize faith-based organizations: Project 2025 suggests that international family planning funds should be redirected to faith-based organizations or organizations with limited experience in reproductive health care. Funding would likely be shifted away from evidence-based family planning services.

These policy shifts could severely restrict access to quality reproductive health services globally, undermining efforts to improve maternal health, reduce unintended pregnancies and prevent unsafe abortions.

The Global Gag Rule in the First Trump Administration

The global gag rule’s expansion under the Trump-Pence administration (2017–2021) had profound global implications for reproductive health advocacy, systems and services. Examining the recent history of the policy reveals its far-reaching consequences, helping advocates anticipate challenges and formulate strategies to protect essential services. Trump’s initial global gag rule set a harmful precedent that included:

  • Expanded reach: The Trump administration extended the gag rule to encompass all global health funding (with the exception of humanitarian assistance), affecting programs related to HIV and AIDS, maternal health and family planning. This forced NGOs to choose between complying with abortion restrictions or losing vital financial support, resulting in decreased contraceptive access and an increase in unsafe abortions. If reinstated, the policy is likely to have similarly devastating effects, compelling health providers to reduce or discontinue critical services once again.
  • Cuts in global health funding: Funding for family planning programs in the Global Health Account was drastically cut, and funding to the UNFPA was also reduced significantly, disrupting UN efforts to provide family planning and reproductive health services, particularly in humanitarian settings.
  • Lasting damage to programs: Guttmacher research in Uganda and Ethiopia captures the far-reaching effects of Trump’s first global gag rule. In both countries, progress toward expanded access to modern contraception stalled or reversed, undermining reproductive health outcomes, limiting individuals’ ability to decide whether and when to have children, and curbing overall bodily autonomy. This research provides two useful case studies for understanding the impact of the policy in similar contexts if reinstated.

Immediate Responses to the Global Gag Rule

What a reinstated global gag rule will entail is not fully clear yet. As advocates and their organizations prepare for changes to their US funding, they can mitigate unnecessary setbacks in the following ways:

  • Know the contract: Reinstatement of the global gag rule will not affect existing contracts and will apply only to new funding agreements.
  • Know the timeline: Organizations are under no obligation to adjust their programs or partnerships to comply with the gag rule before it has been reinstated.
  • Know what is required: Organizations should avoid overinterpreting the policy restrictions and acting beyond what is required. This can lead to unnecessary disruption of services, partnerships and programs that fall outside the purview of the new policy. 

As the new policy takes effect, Guttmacher will update this page with up-to-date information about the reach and limits of the expansion. 

Resources

Background

Guttmacher has long analyzed the global gag rule, focusing on its harmful effects on health systems and human rights. Designed to support advocates, raise awareness and inform policymakers, the following publications aim to address the far-reaching consequences of the gag rule.

Media and advocacy

These resources include helpful tools for media and advocacy efforts, such as infographics and past media articles. They clarify key distinctions, including the difference between the global gag rule and the Helms Amendment, while highlighting potential impacts of policy changes. 

Country case studies

Multiyear research conducted by Guttmacher and partners in Uganda and Ethiopia provides critical evidence on how the global gag rule’s funding restrictions have harmed reproductive health care systems, advocacy and outcomes in two countries with different abortion laws. These resources provide a deeper understanding of the potential impacts of the gag rule in low- and middle-income countries, helping advocates and organizations anticipate the challenges they may encounter if the policy is reinstated.


 

This page is regularly updated to ensure you have access to the latest resources and information. Last updated: January 15, 2025.